Transforming the discharge conversation through support and structure: A scoping review

Area of Science:

• Nursing
• Gerontology
• Health Communication

Background:

• System-level demands and interpersonal barriers impede nurses' ability to provide high-quality discharge information.
• This can lead to inadequate caregiver preparedness and negatively impact patient health outcomes.

Purpose of the Study:

• To synthesize evidence on effective nurse communication strategies with informal caregivers during hospital discharge.
• Focus on adult patients with cognitive decline or Alzheimer's disease and related dementias.

Main Methods:

• A scoping review of inpatient nurse communication with informal caregivers was conducted.
• Research published between 2011 and 2023 was gathered from MEDLINE, PsycINFO, and CINAHL, supplemented by gray literature (N=18).
• Communication practices supporting caregiver activation and preparedness were extracted and synthesized.

Main Results:

• Two main themes emerged: Support and Structure.
• Support included information exchange, dedicated time for preparedness assessment, and positive reinforcement.
• Structure involved setting shared expectations, providing informational resources, and standardization of communication.

Conclusions:

• Practical recommendations are offered for improving nurse-patient caregiver communication at discharge.
• These recommendations address both interpersonal interactions and policy-level facilitators.
• Enhancing communication quality is crucial for caregiver preparedness and patient well-being.